Health Care

The CIA Stops Fake Vaccinations as Real Polio Rebounds

The White House confirmed this week that the Central Intelligence Agency will no longer use vaccination campaigns in its operations, reviving the debate over a surprise comeback of the polio virus. The CIA famously used fake vaccinations during its hunt for Osama bin Laden, which ended in his killing at a Pakistan hideout in 2011. The operation spawned a backlash against vaccination workers that hampered efforts to eradicate the disease there. After the deans of 12 U.S. public health schools complained (PDF) to President Obama in January 2013 of the “collateral damage,” the White House replied on May 16, saying a CIA policy established in August 2013 banned the use of such campaigns.

Why is the White House only answering the letter now?
It always takes time to evaluate whether to disclose details about operations, said a senior administration official. The CIA, for its part, said the agency took seriously the concerns raised by the public health community. “By publicizing this policy, our objective is to dispel one canard that militant groups have used as justification for cowardly attacks against vaccination providers,” Dean Boyd, a CIA spokesman, said by e-mail.

How widespread is the polio outbreak?
The World Health Organization on May 5 declared polio a global health emergency, showing how precarious efforts are to eradicate the disease. After the virus was pinned in 2012 to just three countries where it spreads locally—Pakistan, Afghanistan, and Nigeria—cases have since been reported in Syria, Iraq, Cameroon, Equatorial Guinea, Kenya, Ethiopia, and Somalia. Wars have left many countries with “severely compromised routine immunization services” that could fuel the international spread, Bruce Aylward, WHO’s assistant director general for polio, said on May 5. The United Nations agency recommended that Pakistan, Cameroon, and Syria vaccinate people before they leave those countries.

Is the backlash more deadly than the disease?
As many as 60 polio vaccinators have been killed in Pakistan since December 2012, according to Rotary International, which has helped lead eradication programs. In the first four and a half months of this year, 77 polio cases had been reported globally, 61 in Pakistan, most of those in a Taliban-dominated tribal region where some leaders have banned vaccines. The numbers are up from 33 worldwide in the same period last year. WHO says about one in 200 infections leads to irreversible paralysis, and a small fraction of those result in death.

Did the CIA help cause the rebound in polio?
Laurie Garrett, a senior fellow for global health at the Council on Foreign Relations, says press reports of the CIA ploy did worsen conditions in the fight against the disease. U.S.-led drone strikes didn’t help either. “Things got bad when the bin Laden incident happened,” Mohammad Ibrahim, a Taliban negotiator, said in an interview with Bloomberg News published on May 9. “The militants are not against the polio drive.”

Garrett also notes that there’s a long history of anti-American leaders denouncing vaccines as a CIA plot. Back in 2003, when polio was also on the ropes, a handful of imams in northern Nigeria claimed the vaccines would sterilize children or spread the HIV virus.

Did the White House apologize for using a humanitarian program as cover for a raid?
No, though the May 16 letter from Lisa Monaco, Obama’s assistant for counterterrorism, did say nice things. “Your tireless efforts to improve global health are inspiring,” she wrote to the deans. “Thank you for the work you do.”